Skin fungal infection

Summary
Skin fungal infections are a group of infectious diseases of skin and/or hair caused by fungi, including tinea manuum, tinea pedis, tinea corporis, tinea cruris, tinea capitis, pityriasis versicolor, Malassezia folliculitis, etc. Skin fungal infections are common diseases in dermatology affecting 20%-25% population. The prevalence rate in tropical area or population of certain occupation (e.g. submarine troop, athletes) can reach 50% or even higher. Skin fungal infections cause physical symptoms and can be life-threatening in severe cases. Patients are also psychologically affected due to esthetic concerns.
Causes

Tinea manuum, tinea pedis, tinea corporis, tinea cruris and tinea capitis are caused by dermatophytes, which are contagious between humans, between animal and human, between contaminated object and human, as well as between different infected body parts. Pityriasis versicolor and Malassezia folliculitis are caused by Malassezia species, which are lipophilic yeast colonized on the surface of human skin and can be isolated from the scalp, face, external auditory canal, chest and back. The patient and environment factors also contribute to the disease. Hyperhidrosis, warm and humid climate are risk factors of skin fungal infections.

Symptions

Tinea manuum and tinea pedis: vesicles with clear fluid, pruritis (vesicular form); interdigital maceration and pruritis in patients who often wear occlusive shoes. Subsequent bacterial infection can occur (interdigital form); thickening of stratum corneum and scaling of the palm and sole. Fissures and pain may occur in winter (moccasin form).
Tinea corporis and tinea cruris: manifested by papules, vesicles and reddish macula with clear edge. Scaling and pruritis can be present.
Tinea capitis: breaking up of hair. The scalp may have pustules, secretion and scabbing.
Pityriasis versicolor: localized in lipid-rich areas. This disease is characterized by flaky round or oval macula. Lesions are hyperpigmented and/or hypopigmented.
Malassezia folliculitis: reddish follicular papule with small pustule on the tip. Pruritis of different severity can be present.

Treatment

Skin fungal infections can be treated with topical or oral antifungal agents, or the combination of the two. In highly keratinized area, especially in moccasin form tinea manuum and tinea pedis, topical agent cannot diffuse into the deeper location of the skin and thus oral antifungals should be used. Skin fungal infections of multiple areas should be treated together. To avoid recurrence and spreading, patients should wear air permeable clothes, shoes and socks and not share clothes, towels and shoes with others.
  

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